A Comparison Of Nerve Block And Silver Needle In The Treatment Of Back Myofascial Pain Based On Infrared Thermal Imaging

Objective:To use infrared thermal imaging to measure the temperature in the affected area,and the warm area and the cold area were divided into two groups for silver needle heat conduction and nerve block treatment,then the efficacy was compared to choose the best treatment method for back myofascial pain.Methods:After patients who dignosed with myofascial pain had been examed by infrared thermal imaging,we measured the temperature of the affected side and the relative healthy side(△T=the temperature of affected area-the temperature of healthy area,if the pain is unilateral,the relative healthy side is contralateral area;if the pain is bilateral,the relatively healthy side is the surrounding painless area),100 cases were selected in both warm group(group W,△T≥0.2℃)and the cold group(group C,△T≤-0.2℃),then each group was randomly divided into 2 groups(WS,WN,CS,CN)with 50 patients.Group WS and CS received silver needle heat conduction therapy(S)once in a month,and group WN and CN received nerve block treatment(N)once every 5 days,2 ～ 3times in total depends on how much the pain relieves.The change of patients’ pain were inquired and compared with Visual Analogue Scale(VAS)at day 0(before theatment),7,15,30 and 60 after the treatment.Results:During the follow-up period,the VAS scores of the patients in the group W on the 7,15,30,and 60 days showed that the WS group was significantly higher than that of the WN group.For patients with high temperature,the nerve block effect was better than the silver needle heat conduction treatment;The VAS scores of patients in group C on the 15,30,and 60 days showed that the CS group was significantly lower than that of the CN group.For patients with low temperature,the silver needle treatment effect was better than nerve block.There were statistical differences between the two groups of cold and warm(P<0.05).Conclusion:Patients of myofascial pain were examed by Infrared thermal imaging,and the temperature of the affected side and the relative healthy side were calculated.Nerve block treatment in the warm area(△T≥0.2℃)was effective.The nerve root of the posterior medial ramus of the spinal nerve in the affected area was injected with 2%lidocaine hydrochloride 2ml + total amount of methylprednisolone sodium succinate40 mg + total amount of mecobalamine injection 500μg.In the cold area(△T≤-0.2℃),the silver needle treatment effect is better.The needle is placed at the pain point and the tip reaches the bone.The needle is set at 80-110℃ according to the exposed length of the skin,heated for 20 min,and the needle is pulled out after cooling.